ICU内应激性心肌病:其实并不少见

Stress cardiomyopathy in ICU

应激性心肌病在ICU内并不少见,很多重症患者的病理因素均可诱发应激性心肌病。发病前有明显的诱因,女性患者多见,男性患者并发症的发生率较女性高。临床症状与急性冠状动脉综合征(acute coronary syndrome,ACS)相似,且易与其相混肴,由于其治疗原则相差较大,临床需鉴别诊断。因此在诊断未明确前,按ACS处理,以免错失后者的治疗时机,明确诊断后再按应激性心肌病的处理原则治疗。血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂可提高患者生存率。

Stress cardiomyopathy is common in the ICU, and many pathological factors can induce stress cardiomyopathy. There are clear causative factors before the onset of the disease. The disease is common in women, but the incidence of its complications is higher in men than in women. Its clinical symptoms are similar to acute coronary syndrome. Since the principles for treatment of the disease are quite different, differential diagnosis is required. Before the diagnosis is established, treatment is given according to acute coronary syndrome to avoid loss of the chance of treatment. Angiotensin converting enzyme inhibitors and angiotensinⅡreceptor antagonists can improve the survival rate of patients with stress cardiomyopathy.